Retention anchor for surgical access devices

ABSTRACT

A surgical access assembly includes a cannula and a retention anchor including an annular body and a washer secured to the annular body. The annular body includes an inner side surface defining an opening therethrough, and the washer includes an inner terminal edge defining an opening therethrough that is aligned with the opening of the annular body. The elongated shaft of the cannula extends through the openings. The washer is transitionable between a first configuration in which the inner terminal edge of the washer is coincident with or disposed radially outwardly of the inner side surface of the annular body so that the retention anchor is slidable along the elongated shaft, and a second configuration in which the inner terminal edge of the washer extends radially inwardly of the inner side surface of the annular body and engages the elongated shaft to fix the retention anchor to the elongated shaft.

FIELD

The present disclosure relates generally to surgical access devices. Inparticular, the present disclosure relates to a retention anchor forfixing a surgical access device in tissue.

BACKGROUND

In minimally invasive surgical procedures, including endoscopic andlaparoscopic surgeries, a surgical access device permits theintroduction of a variety of surgical instruments into a body cavity oropening. A surgical access device (e.g., a cannula or an access port) isintroduced through an opening in tissue (e.g., a naturally occurringorifice or an incision) to provide access to an underlying surgical sitein the body. The opening is typically made using an obturator having ablunt or sharp tip that may be inserted through a passageway of thesurgical access device. For example, a cannula has a tube of rigidmaterial with a thin wall construction, through which an obturator maybe passed. The obturator is utilized to penetrate a body wall, such asan abdominal wall, or to introduce the surgical access device throughthe body wall, and is then removed to permit introduction of surgicalinstruments through the surgical access device to perform the surgicalprocedure.

Minimally invasive surgical procedures, including both endoscopic andlaparoscopic procedures, permit surgery to be performed on organs,tissues, and vessels far removed from an opening within the tissue. Inlaparoscopic procedures, the abdominal cavity is insufflated with aninsufflation gas, e.g., CO₂, to create a pneumoperitoneum therebyproviding access to the underlying organs. A laparoscopic instrument isintroduced through a cannula accessing the abdominal cavity to performone or more surgical tasks. The cannula may incorporate a seal toestablish a substantially fluid tight seal about the laparoscopicinstrument to preserve the integrity of the pneumoperitoneum. Thecannula, which is subjected to the pressurized environment, e.g., thepneumoperitoneum, may include an anchor mechanism to prevent the cannulafrom backing out of the opening in the abdominal wall, for example,during manipulation of the laparoscopic instrument within the cannula orwithdrawal of the laparoscopic instrument therefrom.

SUMMARY

This disclosure generally relates to a retention anchor for securing asurgical access device within tissue. The retention anchor provides acounter force during insertion and/or articulation of surgicalinstruments through the surgical access device. In aspects in which thesurgical access device includes an anchor mechanism, the retentionanchor is utilized in conjunction with the anchor mechanism to limitlongitudinal movement of the surgical access device relative to thetissue (e.g., retropulsion and over-insertion) during, for example,receipt, manipulation, and/or withdrawal of surgical instrumentstherethrough.

The retention anchor includes an annular body and a washer affixed tothe annular body that is movable relative thereto. This design increasesthe usability of the retention anchor by maximizing the fixation forceon a surgical access device and minimizing the force required to movethe retention anchor relative to the surgical access device, and makesmanufacturing and assembly easier.

In one aspect, the disclosure provides a surgical access assemblyincluding a cannula and a retention anchor. The cannula includes anelongated shaft, and the retention anchor includes an annular body and awasher secured to the annular body. The annular body includes an innerside surface defining an opening therethrough, and the washer includesan inner terminal edge defining an opening defined therethrough that isaligned with the opening of the annular body. The elongated shaft of thecannula extends through the openings of the annular body and the washer.The washer is transitionable between a first configuration in which theinner terminal edge of the washer is coincident with or disposedradially outwardly of the inner side surface of the annular body so thatthe retention anchor is slidable along the elongated shaft, and a secondconfiguration in which the inner terminal edge of the washer extendsradially inwardly of the inner side surface of the annular body andengages the elongated shaft to fix the retention anchor to the elongatedshaft.

The inner side surface of the annular body may frictionally engage theelongated shaft of the cannula. The inner side surface of the annularbody may include ridges.

The annular body may include a proximally-facing surface, and the washermay be positioned adjacent to the proximally-facing surface. The washermay include an outer terminal edge affixed to the annular body. Theproximally-facing surface of the annular body may define an annularrecess therein and, when the washer is in second configuration, thewasher may be disposed within the annular recess.

In some aspects, when the washer is in the first configuration, thewasher has a convex shape and when the washer is in the secondconfiguration, the washer has a concave shape.

The washer may be more rigid than the annular body. The washer may beformed from a metal and the annular body may be formed from a rubber.

In another aspect, the disclosure provides a retention anchor for asurgical access device including an annular body and a washer secured tothe annular body. The annular body includes an inner side surfacedefining an opening therethrough, and the washer includes an innerterminal edge defining an opening defined therethrough that is alignedwith the opening of the annular body. The washer is transitionablebetween a first configuration in which the inner terminal edge of thewasher is coincident with or disposed radially outwardly of the innerside surface of the annular body, and a second configuration in whichthe inner terminal edge of the washer extends radially inwardly of theinner side surface of the annular body.

The inner side surface of the annular body may include ridges.

The annular body may include a proximally-facing surface, and the washermay be positioned adjacent to the proximally-facing surface. The washermay include an outer terminal edge affixed to the annular body. Theproximally-facing surface of the annular body may define an annularrecess therein and, when the washer is in second configuration, thewasher may be disposed within the annular recess.

In some aspects, when the washer is in the first configuration, thewasher has a convex shape and when the washer is in the secondconfiguration, the washer has a concave shape.

The washer may be more rigid than the annular body. The washer may beformed from a metal and the annular body may be formed from a rubber.

In yet another aspect, a method of securing a surgical access device totissue includes: positioning an elongated shaft of a cannula withintissue; sliding a retention anchor disposed on the elongated shaft ofthe cannula distally until the retention anchor abuts an outer surfaceof the tissue, the retention anchor including an annular body having aninner surface defining an opening therethrough and a washer secured tothe annular body and having an inner terminal edge defining an openingtherethrough that is aligned with the opening of the annular body, theelongated shaft of the cannula extending through the openings of theannular body and the washer, the washer disposed in a firstconfiguration in which an inner terminal edge of the washer iscoincident with or disposed radially outwardly of an inner surface ofthe annular body so that the retention anchor is slidable along theelongated shaft; and moving the washer of the retention anchor to asecond configuration in which the inner terminal edge of the washerextends radially inwardly of the inner side surface of the annular bodyand engages the elongated shaft to fix the retention anchor to theelongated shaft.

Moving the washer may include pressing the washer into an annular recessdefined in the annular body of the retention anchor.

The method may further include expanding an expandable anchor of thecannula against an inner surface of the tissue.

The details of one or more aspects of the disclosure are set forth inthe accompanying drawings and the description below. Other features,objects, and advantages of the aspects described in this disclosure willbe apparent from the description and drawings, and from the claims.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of a surgical access assembly including acannula and a retention anchor in accordance with an aspect of thedisclosure;

FIG. 2 is a perspective view of the retention anchor of the surgicalaccess assembly of FIG. 1 ;

FIG. 3 is cross-sectional view of the surgical access assembly of FIG. 1, taken along section line 3-3 of FIG. 1 , shown with the retentionanchor in a first configuration;

FIG. 4 is a cross-sectional view of the surgical access assembly of FIG.3 , shown with the retention anchor in a second configuration; and

FIG. 5 is a side view of the surgical access assembly of FIG. 1 , showndisposed within tissue.

DETAILED DESCRIPTION

Aspects of the disclosure are described hereinbelow with reference tothe accompanying drawings; however, it is to be understood that thedisclosed aspects are merely exemplary of the disclosure and may beembodied in various forms. Well-known functions or constructions are notdescribed in detail to avoid obscuring the disclosure in unnecessarydetail. Therefore, specific structural and functional details disclosedherein are not to be interpreted as limiting, but merely as a basis forthe claims and as a representative basis for teaching one skilled in theart to variously employ the disclosure in virtually any appropriatelydetailed structure.

Like reference numerals refer to similar or identical elementsthroughout the description of the figures. Throughout this description,the term “proximal” refers to a portion of a structure, or componentthereof, that is closer to a user, and the term “distal” refers to aportion of the structure, or component thereof, that is farther from theuser.

FIG. 1 illustrates a surgical access system 1 including a surgicalaccess device or cannula 10 and a retention anchor 20. The cannula 10generally includes an elongated shaft 12 supporting an instrumenthousing 14 on a proximal or first end portion 12 a thereof and anexpandable anchor 16 (e.g., an inflatable anchor, such as a balloon, ora contractable anchor, such as a collapsible flange) on a distal orsecond end portion 12 b thereof. The expandable anchor 16 secures thecannula 10 against an inner surface of a body wall, such as an abdominalwall, as seen in FIG. 5 .

The retention anchor 20 is supported on the elongated shaft 12 of thecannula 10. The retention anchor 20 is releasably engageable with theelongated shaft 12, and slidable therealong to adjust the position ofthe retention anchor 20 on the elongated shaft 12. The retention anchor20 secures the cannula 10 against an outer surface of the body wall andstabilizes the cannula 10 relative to the body wall.

Generally, the cannula 10 is employed during surgery (e.g., laparoscopicsurgery) to access a surgical site and may, in various aspects, providefor the sealed insertion of surgical instruments into an insufflatedbody cavity, such as an abdominal cavity. The cannula 10 is usable withan obturator (not shown). The obturator generally includes an elongatedbody supporting a tip on a distal end thereof. The tip can have a bladedor non-bladed (e.g., blunt) penetrating distal end that can be used toincise or separate tissue of the body wall so that the cannula 10 can beintroduced therethrough. The cannula 10 and the obturator may be capableof being selectively connected together. For example, the obturator maybe inserted into and through the cannula 10 until a handle housing ofthe obturator engages, e.g., selectively locks into, the instrumenthousing 14 of the cannula 10. In this initial position, the cannula 10and the obturator, which together form a trocar assembly, are employedto tunnel through a body wall, e.g., an abdominal wall, either by makinga new passage through the body wall or by passing through an existingopening through the body wall. Once the trocar assembly has tunneledthrough the body wall, the obturator is removed, leaving the cannula 10in place, e.g., in an incision created by the trocar assembly. Theinstrument housing 14 of the cannula 10 may include an insufflation port15 that provides insufflation fluid (e.g., gases) into the body cavity,seals and/or valves (not shown) that allows surgical instrument to beinserted into the body cavity while preventing the escape of theinsufflation fluid therefrom, and an anchor inflation port 17 which isin fluid communication with the expandable anchor 16 to expand and/orcontract the expandable anchor 16.

For a detailed description of the structure and function of exemplarysurgical access devices suitable for use with a retention anchor of thepresent disclosure, reference may be made to U.S. Pat. Nos: 7,691,089;8,926,508; and 10,299,778, the entire contents of each of which arehereby incorporated by reference herein.

Turning now to FIG. 2 , in conjunction with FIG. 1 , the retentionanchor 20 includes an annular body 22 having a first orproximally-facing surface 24, a second or distally-facing surface 26, anouter side surface 28, and an inner side surface 30. The outer and innerside surfaces 28, 30 extend between and interconnect the first andsecond surfaces 24, 26 and respectively define outer and inner terminaledges 28 a, 30 a of the retention anchor 20.

The inner side surface 30 defines an opening 23 through the annular body22 that is sized and shaped to accommodate the elongated shaft 12 of thecannula 10 in a friction fit manner. The inner side surface 30 of theannular body 22 includes ridges 32 extending into the opening 23 toenhance the grip of the annular body 22 about the elongated shaft 12 ofthe cannula 10 and to limit movement of the retention anchor 20 relativeto the cannula 10. It should be understood that in addition to or as analternative to the ridges 32, the inner side surface 30 of the annularbody 22 may include protrusions, bumps, projections, or other texturedfinishes to aid in retaining the retention anchor 20 on the elongatedshaft 12 of the cannula 10 while allowing movement of the annular body22 relative to the elongated shaft 12.

As shown in FIGS. 3 and 4 , the annular body 22 includes an annularrecess 25 defined in the first surface 24. The annular recess 25 extendsfrom the inner side surface 30 of the annular body 22 radially outwardlytowards the outer side surface 28, but is spaced inwardly of the outerterminal edge 28 a such that the annular recess 25 extends across amajority of the first surface 24 (e.g., across more than about 50% ofthe surface area of the first surface 24 and, in some aspects, acrossmore than 75% of the surface area of the first surface 24). The annularrecess 25 is sized and shaped to retain a washer 34 therein.

The washer 34 is a thin, flat annular disk including an inner terminaledge 34 a defining an opening 35 therethrough, and an outer terminaledge 34 b. The opening 35 is aligned with the opening 23 defined throughthe annular body 22 to accommodate the elongated shaft 12 of the cannula10 therethrough. The washer 34 is positioned adjacent to the firstsurface 24 of the annular body 22 and is transitionable between a firstor clearance configuration having a convex shape, as seen in FIG. 3 ,and a second or interference configuration having a concave shape, asseen in FIG. 4 .

The annular body 22 of the retention anchor 20 is formed from a flexiblematerial, such as rubber, plastic, or other suitable polymer (e.g.,elastomers). The washer 34 is formed from a material that is more rigidthan the annular body 22, such as a metal (e.g., a thin sheet of metal).The washer 34 is affixed to the annular body 22 by over-molding orinsert molding the annular body 22 to the washer 34 such that the outerterminal edge 34 b of the washer 34 is retained within the annular body22 to securely attach the washer 34 to the annular body 22. The washer34 is affixed to the annular body 22 only at the outer terminal edge 34b such that the inner terminal edge 34 a is movable relative to theannular body 22.

The washer 34 has an outwardly biased dome shape, as shown in FIG. 3 ,with the outer terminal edge 34 b of the washer 34 disposed within theannular body 22 and the inner terminal edge 34 a of the washer 34extending upwardly away from the first surface 24 of the annular body22. In this first configuration, the washer 34 has a convex shape, andthe inner terminal edge 34 a of the washer 34 is coincident with ordisposed radially outwardly of the inner side surface 30 of the annularbody 22 so that only the annular body 22 is engaged with the elongatedshaft 12 of the cannula 10 and the retention anchor 20 is free to slidealong the elongated shaft 12.

The washer 34 is transitionable to the second configuration, as shown inFIG. 4 , by pressing the washer 34 towards the annular body 22. Sincethe outer terminal edge 34 b of the washer 34 is affixed to the annularbody 22, the inner terminal edge 34 a of the washer 34 is moveddownwardly into the annular recess 25 of the first surface 24 of theannular body 22. In this second configuration, the washer 34 has aconcave shape, and the inner terminal edge 34 a of the washer 34 extendsradially inwardly of the inner side surface 30 of the annular body 22and engages the elongated shaft 12 of the cannula 10 thereby fixing theretention anchor 20 to the elongated shaft 12 (e.g., locking theretention anchor 20 onto the cannula 10 by friction fit).

FIG. 5 illustrates the surgical access assembly 1 disposed within tissue“T,” e.g., an abdominal wall. The retention anchor 20 is secured to thecannula 10 prior to introducing the cannula 10 into the tissue “T”(e.g., the retention anchor 20 may be pre-installed on the cannula 10during manufacture or may be placed on the cannula 10 prior to use inthe operating room). The elongated shaft 12 of the cannula 10 isreceived through the tissue “T” (e.g., by utilizing an obturator (notshown) to facilitate entry of the cannula 10 through the tissue “T”),and the expandable anchor 16 is inflated within a body cavity “C” toprevent the cannula 10 from being withdrawn through the tissue “T.” Theretention anchor 20, is disposed on the elongated body 12 of the cannula10 in the first configuration (FIG. 3 ) and is slid distally along theelongated shaft 12 of the cannula 10 until the retention anchor 20 abutsor presses on the tissue “T.”

The retention anchor 20 is then transitioned to the second configuration(FIG. 4 ) by pressing the washer 34 down into the annular recess 25 ofthe annular body 22 of the retention anchor 20, in the direction ofarrow “A,” to lock the retention anchor 20 onto the elongated shaft 12of the cannula 10 by friction fit between the washer 34 and theelongated shaft 12. The tissue “T” is thus sandwiched between theexpandable anchor 16 and the retention anchor 20 to prevent the cannula10 from being withdrawn from or over-inserted into the tissue “T.” Inthis manner, the surgical access assembly 1 is secured to the tissue “T”and longitudinal movement of the cannula 10 relative to the tissue “T”is prevented or minimized throughout insertion, withdrawal, and/ormanipulation of a surgical instrument “S” through the cannula 10.

Following the surgical procedure, the expandable anchor 16 is deflatedto permit the withdrawal of the cannula 10 from the tissue “T.” Theretention anchor 20 may remain secured to and disposed about theelongated shaft 12 of the cannula 10 in the second configuration duringwithdrawal of the cannula 10, or may be moved to the first configurationprior to removal of the cannula 10 from the tissue “T” (e.g., byapplying a force against the second surface 26 of the annular body 22towards the first surface 24 to pop the washer 34 back into the firstconfiguration).

While aspects of the disclosure have been shown in the drawings, it isnot intended that the disclosure be limited thereto, as it is intendedthat the disclosure be as broad in scope as the art will allow and thatthe specification be read likewise. It is to be understood, therefore,that the disclosure is not limited to the precise aspects described, andthat various other changes and modifications may be effected by oneskilled in the art without departing from the scope or spirit of thedisclosure. Therefore, the above description should not be construed aslimiting, but merely as exemplifications of aspects of the disclosure.Thus, the scope of the disclosure should be determined by the appendedclaims and their legal equivalents, rather than by the examples given.

What is claimed is:
 1. A surgical access assembly comprising: a cannulaincluding an elongated shaft; and a retention anchor disposed about theelongated shaft and selectively slidable along the elongated shaft, theretention anchor including: an annular body including an inner sidesurface defining an opening through the annular body, the annular bodyincluding a proximally-facing surface defining an annular recess in theproximally-facing surface; and a washer secured to the annular body, thewasher including an inner terminal edge defining an opening through thewasher that is aligned with the opening of the annular body, theelongated shaft of the cannula extending through the openings of theannular body and the washer, the washer transitionable between a firstconfiguration in which the washer has a convex shape and the innerterminal edge of the washer is disposed outside of the annular recess sothat the retention anchor is slidable along the elongated shaft, and asecond configuration in which the washer has a concave shape and theinner terminal edge of the washer is disposed within the annular recessand engages the elongated shaft to fix the retention anchor to theelongated shaft.
 2. The surgical access assembly of claim 1, wherein theinner side surface of the annular body frictionally engages theelongated shaft of the cannula.
 3. The surgical access assembly of claim2, wherein the inner side surface of the annular body includes ridges.4. The surgical access assembly of claim 1, wherein the washer includesan outer terminal edge affixed to the annular body.
 5. The surgicalaccess assembly of claim 4, wherein the outer terminal edge of thewasher is affixed to the annular body radially outwardly of the annularrecess.
 6. The surgical access assembly of claim 1, wherein, when thewasher is in the first configuration, the washer extends proximallyabove the annular recess and, when the washer is in the secondconfiguration, the washer is disposed within the annular recess.
 7. Thesurgical access assembly of claim 1, wherein the washer is more rigidthan the annular body.
 8. The surgical access assembly of claim 7,wherein the washer is formed from a metal and the annular body is formedfrom a rubber.
 9. The surgical access assembly of claim 1, wherein thewasher is a continuous annular disk.
 10. The surgical access assembly ofclaim 1, wherein, when the washer is in the first configuration, theentirety of the inner terminal edge of the washer is disposed outside ofthe annular recess.
 11. A retention anchor for a surgical access device,the retention anchor comprising: an annular body including an inner sidesurface defining an opening through the annular body, the annular bodyincluding a proximally-facing surface defining an annular recess in theproximally-facing surface; and a washer secured to the annular body, thewasher including an inner terminal edge defining an opening through thewasher that is aligned with the opening of the annular body, the washertransitionable between a first configuration in which the washer has aconvex shape and the inner terminal edge of the washer is disposedoutside of the annular recess, and a second configuration in which thewasher has a concave shape and the inner terminal edge of the washer isdisposed within the annular recess.
 12. The retention anchor of claim11, wherein the inner side surface of the annular body includes ridges.13. The retention anchor of claim 11, wherein the washer includes anouter terminal edge affixed to the annular body.
 14. The retentionanchor of claim 11, wherein, when the washer is in the firstconfiguration, the washer extends proximally above the annular recessand, when the washer is in second configuration, the washer is disposedwithin the annular recess.
 15. The retention anchor of claim 11, whereinthe washer is more rigid than the annular body.
 16. The retention anchorof claim 15, wherein the washer is formed from a metal and the annularbody is formed from a rubber.
 17. The retention anchor of claim 11,wherein the washer is a continuous annular disk.
 18. A method ofsecuring a surgical access device to tissue, comprising: positioning anelongated shaft of a cannula within tissue; sliding a retention anchordisposed on the elongated shaft of the cannula distally until theretention anchor abuts an outer surface of the tissue, the retentionanchor including: an annular body having an inner surface defining anopening through the annular body, the annular body having aproximally-facing surface defining an annular recess in theproximally-facing surface; and a washer secured to the annular body, thewasher having an inner terminal edge defining an opening through thewasher that is aligned with the opening of the annular body, theelongated shaft of the cannula extending through the openings of theannular body and the washer, the washer disposed in a firstconfiguration in which the washer has a convex shape and the innerterminal edge of the washer is disposed outside of the annular recess sothat the retention anchor is slidable along the elongated shaft; andmoving the washer of the retention anchor to a second configuration inwhich the washer has a concave shape and the inner terminal edge of thewasher is disposed within the annular recess and engages the elongatedshaft to fix the retention anchor to the elongated shaft.
 19. The methodof claim 18, wherein moving the washer includes pressing the washer intothe annular recess defined in the annular body of the retention anchor.20. The method of claim 18, further including expanding an expandableanchor of the cannula against an inner surface of the tissue.